Q&A with Keith Siegel, RRT, CPFT, AE-C, Director of Respiratory Care and Neurodiagnostics at Pen Bay Medical Center in Rockport, Maine
Keith Siegel is a registered respiratory therapist in charge of managing the Respiratory Care and Neurology departments and Center for Sleep Medicine at a community hospital on the coast of Maine. He has an associate's degree in applied science in respiratory therapy from Southern Maine Community College, and is currently enrolled in a bachelor of science in business administration program at Southern New Hampshire University (graduating in 2012). In addition to being an RRT, Keith is a Certified Pulmonary Function Technologist (CPFT) and Certified Asthma Educator (AE-C). He is also involved with the Maine Society for Respiratory Care and the American Association for Respiratory Care, and believes that "individuals can make a difference" in the lives of others through advocacy.
Q: What motivated you to become a respiratory therapist?
A: I have had significant respiratory issues since I was born, and spent a great deal of my childhood in and out of hospitals. As long as I can remember, I have wanted to work in the medical field working with people with lung disease.
I first learned about the respiratory therapy profession in the late 1970s when I was in high school. I immediately knew that was what I wanted to do with my life. I didn't know any respiratory therapists at the time, so I introduced myself to a respiratory therapist named Jack Higgins, who was working in a nearby hospital. Jack took me under his wing and encouraged me all through RT school. Thirty years later, we are still very good friends, and still work closely together.
Q: Can you describe the facility where you work?
A: Pen Bay Medical Center is a relatively small, 99-bed acute care community hospital. We are part of Maine Health, the state's largest healthcare system. We have an eight-bed ICU and a level II nursery, which means we can intubate and ventilate neonates, but we will always transfer them to a level III NICU. Our facility is a clinical site for respiratory therapy students, as well as nursing, physical therapy, radiology and medical students.
Q: What's it like working at Pen Bay Medical Center?
A: It is a great place to work. The hospital is small enough that it has a very friendly culture, yet large enough that we see lots of interesting cases. The staff (from the frontline caregivers to the hospital administration) is very dedicated to providing patient-focused care. I take special pride in the quality of care that the respiratory therapy, neurology and sleep staff provides to our patients.
The support I get from my vice president and chief operating officer also make me really enjoy my job. They have been particularly supportive in allowing me the time to enroll in business school to advance my management skills. They have also been extremely supportive of the work I do with the Maine Society for Respiratory Care and the American Association for Respiratory Care.
Another wonderful aspect to working at Pen Bay Medical Center is the hospital's location. The hospital looks out over Penobscot Bay. Patients can look out the window in their rooms and see schooners sailing by, as well as many islands. It is very beautiful.
Q: When and how did you start at Pen Bay Medical Center?
A: I grew up in this community and have always wanted to work at Pen Bay Medical Center. My mother was an ICU nurse and a nursing supervisor here for many years. When I graduated from RT school in 1981, there were no openings at Pen Bay (in fact, there was not a respiratory therapy department here in 1981), so I began my career in another hospital. I got a call in early 1983 that Pen Bay Medical Center was opening a new RT department and they wanted me to join the staff. I jumped at the opportunity. I have been here ever since.
Q: Typically, what are your day-to-day responsibilities as a respiratory therapist and director of care?
A: My day-to-day responsibilities are the management of the three departments for which I am responsible. However, I see myself as a respiratory therapist first, and a manager second. I am very happy to grab my lab coat and stethoscope, and go out on the floors to see patients when the RT staff gets busy.
Q: What types of patients/diagnoses do you encounter most frequently?
A: By far, the most common types of diagnoses we see are COPD, asthma and pneumonia patients.
Q: Can you share a motivational story about your career in respiratory therapy?
A: Many years ago, I had a pediatric patient who had a very rare and very severe congenital heart and lung disease. She was not expected to live past the age of 8. She needed a lot of specialized equipment in the home, but was told by our state Medicaid that the equipment would not be paid for because, as they put it, "We've never even heard of that disease."
The little girl's mother was despondent, so I told her that I would take her to see Senator George Mitchell, who in addition to being our United States Senator, was also the Senate Majority Leader. We were able to talk with Senator Mitchell on a Friday afternoon, and on the following Monday, his office called me to say that the little girl was going to get everything she needed. I was not certain if Senator Mitchell could or would help us, but he was amazing. Thanks in part to Senator Mitchell's efforts, my young patient lived many years longer than expected. She finally lost her battle at the age of 17, but her mother and siblings were so grateful for the extra decade they were able to have her with them.
As a result of this, I learned the value of advocacy and that individuals can make a difference. Since that time, I have become very involved with advocacy at the state and national level.
Q: Are there other areas of interest for you as a respiratory therapist, either clinically or educationally, that you plan to pursue?
A: I am currently pursuing a degree in business administration. It used to be understood that clinical managers were promoted into management positions because they were strong clinicians, not because they had strong business skills. In today's difficult economy, this is no longer true. In order to be as competent as possible in my role as manager, I felt the need to get more business training. I will have my BS in Business Administration next year.
Q: What are the greatest challenges you face as a respiratory therapist?
A: The greatest challenge I face is how to continue to carry out our hospital's mission in the face of severely reduced reimbursement. The acuity of the patients that are in the hospital is much greater than it used to be, but every year it seems that the insurers reimburse less and less.
Q: What do you like most about your job? What do you dislike most?
A: What I like most about my job is working with the great respiratory therapists, sleep techs, and others in my areas of responsibility. And I love the fact that I am still able to get out on the floors and do direct patient care. I also enjoy being in a position where I have the authority to move the departments in the directions that I believe will best serve our patients.
Probably the thing I dislike the most would be the constant stress of trying to staff a department 24/7. With only a handful of per diem RTs it can be challenging to adequately staff the department when people are sick or on vacation.
Q: Do you feel that the role of respiratory therapists has changed over recent years?
A: The role of the RT has definitely changed over the years. There are many more opportunities for RTs beyond the traditional role. The greatest change I have seen in the 30 years since I graduated from RT school has been in the level of respect shown to our profession. In the early days, respiratory therapists did not get much respect from the nursing or medical staffs. Now RTs are an integral part of the healthcare team, and the nurses and physicians give us a great deal of respect.
Q: What do you feel is of the greatest concern to respiratory therapists today?
A: Like just about everyone else in America today, I think job security is a significant concern. The days where jobs in healthcare were recession-proof are long gone. Another concern is staffing levels. The RTs in my facility take it very personally if they are unable to get to a patient on time because they are too busy. If patient care is delayed, they feel as if they have not done a good job. I see it as my responsibility to make sure that there is adequate staff to assure that patients are seen on time. However, with our limited resources, it is just as important to make sure that we are not overstaffed. Assuring that staffing levels are appropriate to workload is always challenging. The RT staff in my facility is amazing, in that they voluntarily take time off if workload is light, and willingly work extra if we are understaffed.
Q: What is the most rewarding part of your job?
A: It is very rewarding to manage a staff that takes pride in giving high quality respiratory care to our patients. I love being in a position where I can give the staff the tools they need to do a good job. I also love working in a hospital that is small enough to give personal care, and that my job still allows me the opportunity to do direct patient care.
Q: What is the most important thing you've learned over the course of your career?
A: Perhaps the most important thing I have learned is the value of advocacy. When Senator Mitchell helped us with that little girl, I discovered that we as American citizens can make a difference. Since that time, I have been very involved with advocacy at the local, state and national levels. I have testified at hearings in our state capital for such things as banning smoking in bars and restaurants, and every March I join colleagues from all fifty states on Capitol Hill in Washington, D.C. to advocate for our respiratory patients. As a result of our efforts in D.C., which are organized by the American Association for Respiratory Care, pulmonary rehabilitation is now a covered service under Medicare. This would not have happened without the efforts of RTs around the country advocating for their patients.
Q: What advice do you have for others thinking of entering respiratory management?
A: Respiratory therapy is a great profession. Now more than ever it offers a wide variety of areas in which to specialize. My career evolved into management, and while challenging, it is very rewarding. My advice for people considering going into respiratory management would be first, you have to like people and care about your patients. Also, as I mentioned above, I firmly believe that you should never forget that you are a respiratory therapist first, and a manager second. Once you are in a management position where you are not taking a daily patient assignment, make every effort to get out there on the front lines as often as possible. It will help you maintain the skills you worked so hard to achieve, and will send a strong message to your staff that you have not forgotten what it is like to be a staff respiratory therapist. Nothing makes me more frustrated than seeing clinical managers who think that patient care is beneath them.
Q: How has working in management allowed you to grow professionally?
A: I have grown in many ways over the years that I have been in management. I have been fortunate to have had excellent vice presidents and administrators who have mentored me and allowed me the opportunity to advance my skills by enrolling in business school.
Having said that, however, I believe that most of my professional growth has resulted from my work with the AARC. I have been the Delegate from Maine to the AARC for the last eight years. Being given the opportunity to work with the leaders of our profession has been so inspiring. It is difficult to describe the amount of professional pride I have every time I spend time with my colleagues at the AARC Executive Office and from around the country at AARC meetings.
Q: If you could sum up your job in one word, what would it be and why?
A: Rewarding! I am a respiratory patient, and I know what it is like to be air hungry. Any time I can help relieve a patient's dyspnea, or help educate them on how to prevent exacerbations, it feels great.
Even when I am not the one doing direct patient care, I am so gratified seeing the professionalism and compassion that my staff has toward our patient population. Knowing that I oversee such a fine group of caregivers is extremely rewarding.
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